Accumulated clinical experience contains information directly relevant to clinical management, and thus to the clinical decision process and to the quality of delivered health care. Utilization of prior clinical experience has been impeded by the frailties of memory, the statistical biases of retrospectively recorded data, and most importantly, clinical information. These problems are particularly acute in the major chronic disease areas, where long patient courses, frequent disease fluctuations, interactions of problems in many organs, and uncertain natural history combine to create complicated clinical data and to prevent its adequate interpretation. This proposal will establish a pilot National Chronic Disease computer data bank network in Rheumatic Disease, building upon previous national projects in standardization of the nomenclature of clinical description. The network will enable pooling of clinical data between institutions, inter-institutional studies, rapid access to large quantities of clinical data for participating physicians, and will provide computer consultation and clinical decision procedures based upon this data. It will demonstrate the feasibility of a chronic disease network, including successful function, fruitful collaboration, and documentation of appropriate levels of utilization. Evaluation of the contribution of the system to patient care, teaching, and research will be carried out with an evaluation team of biostatisticians, health economists, and physicians, with particular emphasis upon cost-effective approaches to patient management and to audit of the effectivenss of delivered medical care. The computer network will use Stanford computational facilities, with communication linkages to participating institutions. An interactive, time-sharing PL/C on an IBM 360/67 will serve as the central resource, using a data base software system (TOD) already in place. Retrieval capabilities, statistical procedures, and system audit measurements.